71例急性早幼粒细胞白血病患者白血病细胞免疫表型分析

摘要

This study was purposed to investigate the immunophenotype of leukemia promyelocytes ( LP) and its significance through retrospective analysis of LP immunophenotype and data in new diagnosis of patients with acute promyelocytic leukemia( APL). The immunophenotype of leukemia cells in 71 APL patients was analyzed by means of 6 color immunotyping. The results indicated that MPO, CD33 and CD13 were consistently expressed in leukemia cells of all APL cases with highest average percentages{ >88% ) of positive cells among all studied markers. CD117 was found to be positive in 50.7% , and its average percentage of positive cells was 52. 5%. Leukemia cells in about 10% cases expressed CD15 weakly, and its average percentage of positive cells was 42.5%. CD34 and HLA-DR showed decreased expressions in a small number of cases and were negative in the others. CD2 and CD56 were weakly expressed in nearly 25% APL cases, and the average percentage of positive cells were 39.3% and 42.3% , respectively. Thereby, it is of the opinion that the typical immunophenotype is characterized by MPO+ CD13+ CD33+ CD117+ CD15+ CD34- HLA-DR- in APL. CD2 and CD56 were expressed significantly higher in CD34+ or HLA-DR+ group (including CD34+ HLA-DR+, CD34+ HLA-DR- and CD34- HLA-DR+ ) than in CD34- and HLA-DR" group. Significant differences were also found in WBC and platelet counts, percentage of peripheral blood lcukemic promyelocytes and the expression of CD13 among CD15 < 10% , 10% < CD15 < 20% and CD15 > 20% groups. It is concluded that the APL has a characteristic immunophenotypic profile, flow cytometric immunophenotyping may be considered as a useful tool for rapid recognition of APL and also may be considered to have an important significance for analysing origin of leukemic cells and clinical outcome of patients.%本研究通过回顾性分析急性早幼粒细胞白血病(APL)患者骨髓异常早幼粒细胞的免疫表型及患者初诊资料,探讨其免疫表型特点及其意义.利用常规6色免疫分型方法对71例APL患者的白血病细胞进行免疫表型分析.结果发现:MPO、CD33和CD13在所有患者的APL细胞中都有较强表达,其平均阳性细胞比例达到88％以上.CD117的阳性表达率为50.7％,其平均阳性细胞比例为52.5％.约10％患者的白血病细胞表达CD15,但大部分病例的阳性细胞率都集中在20％ - 40％的弱表达范围内,其平均阳性细胞比例为42.5％.少数患者的异常细胞表达CD34和HLA-DR,且表达强度较弱.约25％患者的APL细胞跨系表达了CD2、CD56,大部分也都集中于20％ - 60％的低表达范围内,其平均阳性细胞比例分别为39.3％和42.3％.由此认为,APL的典型免疫表型为MPO+ CD13+ CD33+ CD117± CD15± CD34- HLA-DR-.CD2和CD56在CD34+或HLA-DR+组(包括CD34+ HLA-DR+、CD34+ HLA-DR-和CD34 - HLA-DR+)的阳性比例明显高于CD34-和HLA-DR -组.初诊患者外周血白细胞计数、血小板计数、外周血中异常早幼粒细胞比例及CD13的阳性比例在CD15＜ 10％、10％＜ CD15＜ 20％和CD15＞20％3组均出现显著的统计学差异.结论:APL患者的异常早幼粒细胞的免疫表型具有独特的特征,多色流式细胞术检测可辅助APL的快速诊断,对分析白血病细胞的来源和判断患者预后亦可能有着重要意义.